Computed tomography( CT) of the hip joint in Moscow
Time: 30-60 seconds, with a contrast of 20 minutes
The need for contrast medium: according to the indication of the doctor
The need for preliminary preparation: no
Restrictions: weight - up to 200kg
Time to prepare conclusion: 15-20 minutes
Children: from age 14
To register for the study, find out how the computerized tomography of the hip is performed, specify the price of the procedure and other informationit is possible by phone +7( 495) 363-40-76 .
CT( computed tomography) of the hip joint is a non-invasive diagnostic method, by which a layered image of its tissues is obtained with visualization of all structural elements. In addition to the joint, the examination area captures the iliac bone, the upper part of the femur and the soft tissues surrounding these formations. With the help of CT, it is possible to diagnose aseptic necrosis of the femoral head and to draw a conclusion about predisposition to its appearance, to reveal deforming osteoarthritis and other degenerative changes. This technique allows you to determine the decrease in bone density with a risk of fracture of the femoral neck and see other pathologies that appear in young and old age. If it is necessary to identify a particular disorder at an early stage, CT scans of two hip joints are performed at once to enable comparison.
Advantages of the
method The study is characterized by high accuracy and reduced "sensitivity" to artifacts, so it can be used to determine any diseases and injuries of the hip joint, from a hidden intraarticular fracture to detachment of the trochanter.
Due to the ability to perform measurements, during the study, important factors such as the circumference, distance between the joint surfaces( acetabulum of the ilium and hip head), etc. are determined.
With the help of three-dimensional reconstruction it is possible to accurately determine the position of bone fragments in complex multifragment fractures of the femoral and pelvic bones, to "find" foreign bodies, to make sure that they are connected or not connected with anatomical structures, and to make an accurate tactic of their extraction.
The small radial load allows repeated studies, which allows, for example, to monitor the condition of the bone callus and to control fusion growth.
If you have a question about where to make a CT of the hip joint in Moscow, you can contact our center - we carry out diagnostics on modern machines with an advanced software and hardware module:
- Optima CT660, General Electric( USA) - 64 slices;
- SOMATOM Emotion 16, Siemens( Germany) - 16 slices;
- SOMATOM Definition Flash, Siemens( Germany) - 2 tubes of 68 slices;
- Somatom Definition 64, Siemens( Germany) - 128 slices, 1mm.
Indications for CT of the hip joint
- fractures, tissue hemorrhage, ruptured capsules, bone fragments and other acute injuries;
- complications of injuries: intra-articular bleeding, wounds of bone fragments of vessels and soft tissues, damage to the sciatic nerve, etc.;
- deforming osteoarthrosis of the hip joints;
- foreign bodies of the joint, bones, soft tissues;
- arthritis of the hip joints, for example, with Reiter's disease;
- aseptic necrosis of the head of the femur;
- malignant and benign neoplasms of bones, joints or soft tissues.
Contraindications to CT of the hip joint
CT is never performed during pregnancy, regardless of its length. X-ray radiation, even in small doses, can have a teratogenic( provoking appearance of fetal pathologies) effect.
The study can not be performed if the patient's body weight exceeds the permissible values. The weight limit for our machines is 200 kg.
CT with contrasting has additional limitations. It can not be performed under the following conditions:
- intolerance of contrast medium, including allergies to its main constituent - iodine - this can lead to severe consequences;if allergy symptoms appear unexpectedly during the study, it is immediately stopped;
- Renal failure - if a patient has a severe kidney pathology, this can slow the elimination of contrast from the body. As a result, the drug may have a toxic effect or provoke the development of an allergy;
- breastfeeding - the contrast penetrates into breast milk, so it is not safe to apply the baby to the breast within 48 hours after the test;
- Severe condition of the patient - if a person has serious injuries, is in coma or shock, a study with contrast is too long and difficult procedure that can not be performed without the potential harm to health caused by delayed care.
Alternative methods Expand
Sometimes CT can be replaced by radiography of the hip joint. Since this is a large formation, on X-ray images its visualization is quite distinct. X-ray examination can be used to determine fractures, osteoarthrosis, signs of arthritis, etc.
For the primary lesion of soft tissues( articular cartilage, ligament, tendons), magnetic resonance imaging should be assigned. With it, you can evaluate in detail the integrity of the joint capsule, the destruction of cartilage, the state of synovial bags, etc.
The hip joint is suitable for puncture, so if you suspect a purulent arthritis or a joint bleeding, you can take the synovial fluid for analysis.
In rare cases, patients are prescribed arthroscopy.
For limited indications, a radionuclide study is possible.
How to conduct CT of the hip joint Expand
Before starting the study, it is advisable to remove metal things from your pockets and remove clothes with metal buckles and buttons so as not to create artifacts in the pictures.
The examination is performed in the supine position;during it you will be on a mobile tomograph table.
If you intend to use contrast, it will be injected intravenously.
Then you are waiting for a short preparation stage, when the doctor determines the area of research and selects the mode of operation of the device.
During the research, only you will be in the room, but with some problems you can always contact the technologist by two-way communication.
While the procedure continues, the table will move inside the tunnel, and the tomograph ring will rotate around the table. In this case, the device will produce a slight noise.
The procedure is not accompanied by any sensations.
Preparation for CT of the hip joint Expand
Prepare for the study only when it is carried out by an enhanced technique. When using contrast, the patient should come to the examination on an empty stomach. With you it is necessary to take all available medical documents: doctor's direction, an extract from the card, the results of previous examinations. They should be shown to the doctor before the procedure begins.
Contrast enhancement Expand
Compared to other joints, the hip often requires the use of contrast. This is the only joint in the body, inside of which there is a large artery. During injuries, it can be damaged, and as a result, there is a need to determine the state of blood flow in the upper part of the thigh. In addition to circulatory disorders, CT with contrast reveals malignant neoplasms and pathology of soft tissues. Contrasting drug iodine-based Yopamiro or Omnipak is injected into the vein. As it is distributed in tissues, it accumulates in pathological foci and makes them more distinct in the pictures. In contrast research, the differentiation of healthy tissues also increases.
Doctor's conclusion Expand
The conclusion is written within 15 minutes. In it, the doctor reflects the pathological changes seen and gives the results of the measurements.
At the request of the patient, the results can be recorded on an electronic medium or sent by mail.
If any disease is found, you should consult a specialist with pictures and their description:
- , most hip problems associated with injuries are dealt with by traumatologists;
- deforming osteoarthritis can be treated by both traumatologists and therapists;
- if you suspect a tumor, you need to make an appointment with an oncologist.
Opportunity of research for children Expand
Computer tomography of the hip joint in our center is conducted for children from 14 years of age.
Where can I make CT of the hip jointExpand
Moscow residents can make CT of the hip joint in all areas of the city:
The need for computed tomography of the hip joints in the presence of other indications is determined by the doctor. Do you need preparation for diagnosis?
Preparation for computer diagnostics is necessary if a contrast medium is used. For 5-6 hours before the tomography of the hip joints, you must stop eating. In other cases, training is not required.
How is the tomography of
? The patient lies on his back. The table on which it is located, moves inside the ring part of the tomograph. During operation, the unit can emit a quiet noise. CT of the hip joint is a painless kind of diagnosis.
The physician is not present in the office, but watches the procedure. Two-way communication with the patient is established.
Duration of CT of the hip joint - no more than a minute. If a contrast medium is used - about 20 minutes. The results of computed tomography( pictures and their description) are prepared by the doctor within 30 minutes.
Joint tomography with contrast
Contrast is a medical preparation that is administered intravenously. It accumulates in the joint area, allowing clearer visualization of soft structures. Computed tomography of the hip joint is performed quite often. After all, a large artery passes through it, which is difficult to visualize by other methods. This vessel is often damaged by trauma to the hip area. The contrast is nontoxic, excreted from the body in 24-36 hours.
Alternative methods of diagnosis
The hip joint is quite large in size, so it is often used for its diagnosis of conventional radiography. Such a study is effective for visualization of fractures, arthritis, arthrosis, X-ray foreign bodies.
If it is necessary to investigate soft structures of the hip joint( cartilage, articular capsule, synovial bags, muscle-ligament apparatus, tendons), then an MRI is prescribed.
Among the common invasive methods used to determine the type of fluid accumulated in the joint cavity - puncture. The joint bag is punctured. Then the obtained sample of liquid is subjected to a histological analysis. Arthroscopy, during which an endoscope is inserted into the joint, is rarely prescribed for the study of the hip joint is rarely prescribed.
MRI and CT of the hip joint, what shows?
- 7 Results of the
Study Methods of radiation diagnosis are the leading ones for any pathology of the musculoskeletal system, and especially for such a complex joint as the hip joint.
Radiography can not always provide enough information, to visualize the soft structures of the joint to the desired degree. Therefore, at the present stage, X-ray is the primary method of diagnosis, and for the detection of serious pathology, preoperative preparation, it is necessary to use new and perfect procedures.
Modern research methods
Such manipulations include magnetic resonance imaging and computed tomography. These two methods allow to detect the pathological process at an early stage, to establish the degree of damage, to build a three-dimensional hip joint model for adequate treatment.
It is worth mentioning that CT and MRI are costly procedures, therefore the doctor should really evaluate the indications for the study and designate them only if necessary.
How is the research conducted? What is the indication for the appointment of modern radiation techniques? To begin with, it is worthwhile to understand the principle of the operation of devices for magnetic resonance and computed tomography.
Principle of operation MRI
The hip joint is a complex formation consisting of bone, cartilaginous, ligamentous and muscular elements. On the X-ray, only hard tissues can be found - bone. To assess the state of the soft components of the joint, the magnetic resonance method is applied.
Part of the human body placed in the magnetic field of the apparatus undergoes a complex of physico-chemical effects.
In different in the density and content of hydrogen elements, tissues are polarized molecules. Changing the charge is picked up by the MRI device and displayed on the computer.
As a result, an image appears on the monitor screen, on which each tissue - whether cartilage or a bunch - looks like a separate formation. The resulting picture can be printed on film for placement in the patient's medical history or consultation with other specialists.
Computer technology allows you to create a three-dimensional model of the joint based on the resulting sections of images. The resulting image will provide invaluable assistance to the surgeon in preparing for surgery on the hip joint.
It is worth noting that magnetic resonance imaging best visualizes soft tissues, which include cartilage, ligaments, joint capsule. This determines the indications for the procedure:
- Rheumatoid arthritis, Bechterew's disease, Reiter's syndrome, other systemic joint diseases.
- Infectious arthritis of the hip joint.
- Hemarthrosis is a collection of blood in the joint cavity.
- Anomalies in the development of the hip area.
- Damage to nerves passing through the joint.
- Osteochondropathies - diseases of cartilage tissue( Perthes disease and others).
- Tumors, including metastases in articulation.
The above readings may be the cause of the magnetic resonance assignment. Some pathological conditions can be diagnosed by other methods, but the most valuable is the MRI.
If the attending physician, despite the high cost of the procedure, assigns this particular study, it is worthwhile to heed his recommendations.
Principle of operation of CT
Another modern diagnostic study is computed tomography. This method is valuable for the accurate visualization of solid bone tissue, as well as the ability to manipulate contrast to obtain more reliable results.
The principle of operation of CT is significantly different from the mechanism of magnetic tomography. In this procedure, the part of the body to be examined( the hip joint) is also placed in the apparatus, which is a tube. The machine takes a snapshot of the articulation by passing through the tissues of a number of rays similar to X-rays.
A distinctive feature is the study in several sections and planes, which allows you to obtain a series of images on your computer.
The resulting images can also be combined into a single three-dimensional image. The disadvantage is the irradiation of tissues in the apparatus, which does not allow the method to be used in the study of children and pregnant women.
Compared with MRI of hip joints, computed tomography better visualizes bone tissue. In the diagnosis of diseases of this region, this feature of the method makes it possible to use CT in the following conditions:
- Complex, intraarticular fractures( cervical hip, pelvic bones).
- Dislocations of the head of the femur.
- Tumors of the thigh, cancer metastasis in the joint.
- Coxarthrosis - deforming arthrosis of the hip joint.
- Presence in the cavity of articulation of foreign bodies.
- Aseptic necrosis of the femoral head.
- Preoperative preparation.
- Postoperative treatment control.
The list of indications for the use of CT can be continued with the use of contrasting joint cavity, as well as in the ineffectiveness of other research methods.
Contraindications and complications
Magnetic resonance imaging has a minimum of contraindications to use, which are limited to the presence in the body of metal formations( prostheses, hearing aids, foreign bodies).
CT is not recommended for pregnant women and children due to high radiation exposure.
Also, a severe condition of the patient, acute surgical pathology, mental illnesses can become a limitation to conducting the procedures. When using contrast agents, the contraindication is individual intolerance, allergic reactions to chemical agents in the anamnesis.
Complications in both magnetic tomography and CT are extremely rare. The chance of allergy is reduced to a minimum, and in the procedural always there is a set with drugs to eliminate the hypersensitivity reaction.
Occasionally, an attack of claustrophobia occurs during the study. When there are unpleasant sensations, feelings of nausea, fear, you need to inform the medical staff using the button that activates the microphone.
How is CT and MRI of the hip joint performed? The procedure for preparing for manipulation is as simple as possible for the patient. There are no restrictions in the diet before the study, you do not need to prepare skin integuments.
The investigated part of the body is placed in the apparatus, which within 20 minutes - half an hour makes pictures of the hip joint. Manipulation is absolutely painless, in most cases not felt by the patient.
The medical personnel during the procedure is located behind a protective glass in the same room as the patient. In the event of any complaints, unpleasant sensations, it is recommended to contact the nurse by pressing the microphone button.
Sometimes, visualization of intraarticular soft formations, as well as assessment of the state of the vasculature, is carried out by contrasting the introduction of special substances visible in the image. Contrast can be injected into the joint cavity or intravenously.
In the first method, a soft tissue puncture is performed on the hip joint in front or behind.
For anesthesia, the injection site is premanched with novocaine. To distribute contrast on the articular bag of the patient may be asked to move, walk around the manipulation room.
Intravenous administration of the substance allows to assess the state of the vessels. In traumatology and orthopedics, the technique is used extremely rarely. Contraindications to the use of contrast - pregnancy, hypersensitivity to a chemical substance.
Results of the
study After the CT and MRI of the hip joint, the patient receives images of the study area in different sections. These images are transmitted to the attending physician, who assesses the joint condition and detects the presence of the following abnormalities:
- Exostoses and osteophytes are outgrowths of bone tissue.
- Breach of integrity of bone, ligaments, cartilage.
- Developmental anomalies.
- Dislocations and subluxations of the femoral head.
- Foreign bodies.
MSCT( computed tomography) of the hip joint - today very informative method of examination, on par with MRI, since it allows to conduct thin sections of tissues( less than 1 mm) and carry out 3D reconstruction of the image if necessary. Computed tomography of the hip joint allows visualization of part of the iliac bone, hip joint and soft tissues surrounding the joint. MSCT of the hip joint can diagnose various joint diseases, such as arthrosis or aseptic necrosis, hip fractures. In addition, MSCT of the hip joint provides information on bone density in this area and to a certain extent predict possible fractures associated with osteoporosis. In order to determine the degree of change, in some cases, it is recommended to compare the MSCT of two joints for comparison.
Indications for computed tomography( MSCT) of the hip joint
- Diagnosis of joint or hip pain of unknown origin
- Aseptic( avascular) necrosis of femoral head
- Arthrosis of hip joint( coxarthrosis)
- Injury of hip joint( joint capsule, muscle, ligament)
- Complications of hip joint injuries( internal bleeding, joint capsules ruptureetc.)
- Fractures of bone structures( pelvis, hips)
- Congenital malformations of the joint( dysplasia or hypoplasia)
- Volumetric joint and soft tissue formation( osteoma, oPaget's disease, etc.)
- Calve Perthes disease
Contraindications for MSCT of the hip joint
- MSCT is not performed in the presence of pregnancy
- MSCT with contrast is not performed if there is an allergy to the contrast
- The presence of decompensated somatic pathology( renal failure, cardiacfailure), especially when it comes to conducting a study with contrast, is a contraindication for MSCT.
- When carrying out a breastfeeding mother's study with contrast, breastfeeding should be excluded within 48 hours after computed tomography with contrast.
The advantages of computed tomography( MSCT)
- Computed tomography( MSCT) is a very accurate and informative research method that allows you to quickly and accurately visualize the structure of the hip joint.
- The presence of metal in the body is not a contraindication for the research, as in the MRI study, and this is the most optimal method of research in the presence of metal implants in the body( endoprostheses, plates, pins) or implanted electronic devices.
- The possibilities of three-dimensional reconstruction allow both the planning of surgical treatment and the evaluation of the results of surgical treatment, especially when it comes to the installation of joint endoprostheses or osteosynthesis using metal fixatives.
- Quality visualization of bone structures in some cases exceeds the ability of MRI.
- The study takes a maximum of several minutes, which is very important in emergency situations( for example, in trauma) and allows you to quickly diagnose and help the patient.
- The radiation load on modern MSCT tomographs is insignificant, and therefore the risk of harmful exposure to X-rays to the body is minimal, and the diagnostic value of this method of investigation is significantly higher than the risk of harmful effects.
- If you need a better visualization of soft tissues( ligaments, muscles, tendons), you can conduct an MRI study that has certain advantages over MSCT.